Urinary tract infection (UTI) caused by uropathogenic Escherichia coli (UPEC) is one of the most common infectious diseases in women. The morbidity and economic impact are enormous, with over $2.5 billion spent annually on treatment. Further, recurrent infections are a significant problem despite appropriate antibiotic therapy of the index case. The high rates of recurrence, and the large numbers of women that end up in urology clinics due to their chronic recurrent UTIs highlights the need for a better understanding of the pathogenic mechanisms involved in this disease and the development of new and better therapies. The high frequency of same-strain recurrences supports the notion that a UPEC quiescent intracellular reservoir (QIR) can exist in the affected individual, and persist even after antibiotic therapy and urine cultures become sterile. Current diagnostic schemes for these bacteria are based on culture and do not distinguish between strains with high or low virulence potential.
Therefore, there is a need for an effective biomarker for urinary tract infections that avoids false negative results that occur when culture-based methods are applied during antibiotic therapy or when culture or nucleic acid-based methods are applied to patients in which bacteria are not actively shed into sampled fluids. In addition, there is a need for effective treatments that can cure urinary tract infections and prevent infection by quiescent intracellular reservoirs of pathogenic bacteria that are the source of so many recurrent urinary tract infections.